弥漫性食管痉挛的诊治进展
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摘要
弥漫性食管痉挛(DES)是一种以引起吞咽困难或胸痛为主要症状的罕见的食管动力障碍,其病因可能与食管抑制性神经功能障碍、食管肌肉厚度增加、胃食管连接处松弛障碍及膈上憩室相关,但其具体机制目前仍未明确。本文将结合目前关于DES的相关研究,在DES的发病机制、诊断以及治疗方法等方面进行综合论述。
Diffuse esophageal spasm(DES) is an uncommon esophageal motility disorder associated with dysphagia or chest pain. The cause of this disease may be related to esophageal inhibitory neurological dysfunction, esophageal muscle thickness increasing, esophagogastric junction relaxation disorder and diaphragmatic diverticulum. But the specific mechanism of DES is still unknown. This paper comprehensive elucidates the latest advancement in pathogenesis, diagnostis and therapy of diffuse esophageal spam.
Diffuse esophageal spasm(DES) is an uncommon esophageal motility disorder associated with dysphagia or chest pain. The cause of this disease may be related to esophageal inhibitory neurological dysfunction, esophageal muscle thickness increasing, esophagogastric junction relaxation disorder and diaphragmatic diverticulum. But the specific mechanism of DES is still unknown. This paper comprehensive elucidates the latest advancement in pathogenesis, diagnostis and therapy of diffuse esophageal spam.
引文
[1]Achem SR.Diffuse esophageal spasm in the era of high-resolution manometry[J].Gastroenterol Hepatol(NY),2014,10(2):130-133.
[2]Gibbins I.Functional organization of autonomic neural pathways[J].Organogenesis,2013,9(3):169-175.
[3]Valdovinos MA,Zavala-Solares MR,Coss-Adame E.Esophageal hypomotility and spastic motor disorders:current diagnosis and treatment[J].Current Gastroenterology Reports,2014,16(11):421.
[4]Roman S,Kahrilas PJ.Distal esophageal spasm[J].Dysphagia,2012,27(1):115-123.
[5]Chaudhury A.Molecular handoffs in nitrergic neurotransmission[J].Front Med(Lausanne),2014,1:8.
[6]Kim TH,Patel N,Ledgerwood-Lee M,et al.Esophageal contractions in type 3 achalasia esophagus:simultaneous or peristaltic?[J].Am JPhysiol Gastrointest Liver Physiol,2016,310(9):G689-G695.
[7]Taniguchi Y,Takahashi T,Nakajima K,et al.Multiple huge epiphrenic esophageal diverticula with motility disease treated with video-assisted thoracoscopic and hand-assisted laparoscopic esophagectomy:a case report[J].Surg Case Rep,2017,3(1):63.
[8]Martinez JC,Lima GR,Silva DH,et al.Clinical,endoscopic and manometric features of the primary motor disorders of the esophagus[J].Arq Bras Cir Dig,2015,28(1):32-35.
[9]Samo S,Carlson DA,Kahrilas PJ,et al.Ineffective esophageal motility progressing into distal esophageal spasm and then type III achalasia[J].ACG Case Reports J,2016,3(4):e183.
[10]Pandolfino JE,Roman S,Carlson D,et al.Distal esophageal spasm in high-resolution esophageal pressure topography:defining clinical phenotypes[J].Gastroenterology,2011,141(2):469-475.
[11]Carlson DA,Pandolfino JE.High-Resolution manometry in clinical practice[J].Gastroenterol Hepatol(NY),2015,11(6):374-384.
[12]Karamanolis G,Triantafyllou K,Psatha P,et al.Bravo 48-hour wireless p H monitoring in patients with non-cardiac chest pain.Objective gastroesophageal reflux disease parameters predict the responses to proton pump inhibitors[J].Journal of Neurogastroenterology and Motility,2012,18(2):169-173.
[13]Triadafilopoulos G,Tandon A,Shetler KP,et al.Clinical and p Hstudy characteristics in reflux patients with and without ineffective oesophageal motility(IEM)[J].BMJ Open Gastroenterology,2016,3(1):e000126.
[14]Cho YK,Choi MG,Oh SN,et al.Comparison of bolus transit patterns identified by esophageal impedance to barium esophagram in patients with dysphagia[J].Dis Esophagus,2012,25(1):17-25.
[15]Lipe DN,Borden N.Rare radiological pattern of diffuse esophageal spasm[J].West J Emerg Med,2015,16(3):426-427.
[16]Licurse MY,Levine MS,Torigian DA,et al.Utility of chest CT for differentiating primary and secondary achalasia[J].Clin Radiol,2014,69(10):1019-1026.
[17]Almansa C,Heckman MG,De Vault KR,et al.Esophageal spasm:demographic,clinical,radiographic,and manometric features in 108 patients[J].Dis Esophagus,2012,25(3):214-221.
[18]Nilsson S,J?remo P.Non-coronary chest pain does not affect long-term mortality:a prospective,observational study using a matched population control[J].BMC Fam Pract,2016,17(1):159.
[19]Coss-Adame E,Erdogan A,Rao SS.Treatment of esophageal(non-cardiac)chest pain:review[J].Clin Gastroenterol Hepatol,2014,12(8):1224-1245.
[20]Hershcovici T,Achem SR,Jha LK,et al.Systematic review:the treatment of noncardiac chest pain[J].Aliment Pharmacol Ther,2012,35(1):5-14.
[21]Nguyen TM,Eslick GD.Systematic review:the treatment of noncardiac chest pain with antidepressants[J].Aliment Pharmacol Ther,2012,35(5):493-500.
[22]Wang W,Sun YH,Wang YY,et al.Treatment of functional chest pain with antidepressants:a meta-analysis[J].Pain Physician,2012,15(2):E131-E142.
[23]Nassri A,Ramzan Z.Pharmacotherapy for the management of achalasia:Current status,challenges and future directions[J].World J Gastrointest Pharmacol Ther,2015,6(4):145-155.
[24]Roman S,Kahrilas PJ.Management of spastic disorders of the esophagus[J].Gastroenterol Clin North Am,2013,42(1):27-43.
[25]Brisinda G,Sivestrini N,Bianco G,et al.Treatment of Gastrointestinal Sphincters spasms with botulinum toxin A[J].Toxins,2015,7(6):··1882-1916.
[26]Lee JH,Kim CG.Botulinum toxin injection for the treatment of delayed gastric emptying following pylorus-preserving gastrectomy:an initial experience[J].J Gastric Cancer,2017,17(2):173-179.
[27]Minami H,Isomoto H,Yamaguchi N,et al.Peroral endoscopic myotomy(POEM)for diffuse esophageal spasm[J].Endoscopy,2014,46Suppl 1:e79-e81.
[28]Khan MA,Kumbhari V,Ngamruengphong S,et al.Is POEM the answer for management of spastic esophageal disorders?A systematic review and meta-Analysis[J].Dig Dis Sci,2017,62(1):35-44.
[29]Kumbhari V,Tieu AH,Onimaru M,et al.Peroral endoscopic myotomy(POEM)vs laparoscopic Heller myotomy(LHM)for the treatment of Type III achalasia in 75 patients:a multicenter comparative study[J].Endosc Int Open,2015,3(3):e195-e201.
[2]Gibbins I.Functional organization of autonomic neural pathways[J].Organogenesis,2013,9(3):169-175.
[3]Valdovinos MA,Zavala-Solares MR,Coss-Adame E.Esophageal hypomotility and spastic motor disorders:current diagnosis and treatment[J].Current Gastroenterology Reports,2014,16(11):421.
[4]Roman S,Kahrilas PJ.Distal esophageal spasm[J].Dysphagia,2012,27(1):115-123.
[5]Chaudhury A.Molecular handoffs in nitrergic neurotransmission[J].Front Med(Lausanne),2014,1:8.
[6]Kim TH,Patel N,Ledgerwood-Lee M,et al.Esophageal contractions in type 3 achalasia esophagus:simultaneous or peristaltic?[J].Am JPhysiol Gastrointest Liver Physiol,2016,310(9):G689-G695.
[7]Taniguchi Y,Takahashi T,Nakajima K,et al.Multiple huge epiphrenic esophageal diverticula with motility disease treated with video-assisted thoracoscopic and hand-assisted laparoscopic esophagectomy:a case report[J].Surg Case Rep,2017,3(1):63.
[8]Martinez JC,Lima GR,Silva DH,et al.Clinical,endoscopic and manometric features of the primary motor disorders of the esophagus[J].Arq Bras Cir Dig,2015,28(1):32-35.
[9]Samo S,Carlson DA,Kahrilas PJ,et al.Ineffective esophageal motility progressing into distal esophageal spasm and then type III achalasia[J].ACG Case Reports J,2016,3(4):e183.
[10]Pandolfino JE,Roman S,Carlson D,et al.Distal esophageal spasm in high-resolution esophageal pressure topography:defining clinical phenotypes[J].Gastroenterology,2011,141(2):469-475.
[11]Carlson DA,Pandolfino JE.High-Resolution manometry in clinical practice[J].Gastroenterol Hepatol(NY),2015,11(6):374-384.
[12]Karamanolis G,Triantafyllou K,Psatha P,et al.Bravo 48-hour wireless p H monitoring in patients with non-cardiac chest pain.Objective gastroesophageal reflux disease parameters predict the responses to proton pump inhibitors[J].Journal of Neurogastroenterology and Motility,2012,18(2):169-173.
[13]Triadafilopoulos G,Tandon A,Shetler KP,et al.Clinical and p Hstudy characteristics in reflux patients with and without ineffective oesophageal motility(IEM)[J].BMJ Open Gastroenterology,2016,3(1):e000126.
[14]Cho YK,Choi MG,Oh SN,et al.Comparison of bolus transit patterns identified by esophageal impedance to barium esophagram in patients with dysphagia[J].Dis Esophagus,2012,25(1):17-25.
[15]Lipe DN,Borden N.Rare radiological pattern of diffuse esophageal spasm[J].West J Emerg Med,2015,16(3):426-427.
[16]Licurse MY,Levine MS,Torigian DA,et al.Utility of chest CT for differentiating primary and secondary achalasia[J].Clin Radiol,2014,69(10):1019-1026.
[17]Almansa C,Heckman MG,De Vault KR,et al.Esophageal spasm:demographic,clinical,radiographic,and manometric features in 108 patients[J].Dis Esophagus,2012,25(3):214-221.
[18]Nilsson S,J?remo P.Non-coronary chest pain does not affect long-term mortality:a prospective,observational study using a matched population control[J].BMC Fam Pract,2016,17(1):159.
[19]Coss-Adame E,Erdogan A,Rao SS.Treatment of esophageal(non-cardiac)chest pain:review[J].Clin Gastroenterol Hepatol,2014,12(8):1224-1245.
[20]Hershcovici T,Achem SR,Jha LK,et al.Systematic review:the treatment of noncardiac chest pain[J].Aliment Pharmacol Ther,2012,35(1):5-14.
[21]Nguyen TM,Eslick GD.Systematic review:the treatment of noncardiac chest pain with antidepressants[J].Aliment Pharmacol Ther,2012,35(5):493-500.
[22]Wang W,Sun YH,Wang YY,et al.Treatment of functional chest pain with antidepressants:a meta-analysis[J].Pain Physician,2012,15(2):E131-E142.
[23]Nassri A,Ramzan Z.Pharmacotherapy for the management of achalasia:Current status,challenges and future directions[J].World J Gastrointest Pharmacol Ther,2015,6(4):145-155.
[24]Roman S,Kahrilas PJ.Management of spastic disorders of the esophagus[J].Gastroenterol Clin North Am,2013,42(1):27-43.
[25]Brisinda G,Sivestrini N,Bianco G,et al.Treatment of Gastrointestinal Sphincters spasms with botulinum toxin A[J].Toxins,2015,7(6):··1882-1916.
[26]Lee JH,Kim CG.Botulinum toxin injection for the treatment of delayed gastric emptying following pylorus-preserving gastrectomy:an initial experience[J].J Gastric Cancer,2017,17(2):173-179.
[27]Minami H,Isomoto H,Yamaguchi N,et al.Peroral endoscopic myotomy(POEM)for diffuse esophageal spasm[J].Endoscopy,2014,46Suppl 1:e79-e81.
[28]Khan MA,Kumbhari V,Ngamruengphong S,et al.Is POEM the answer for management of spastic esophageal disorders?A systematic review and meta-Analysis[J].Dig Dis Sci,2017,62(1):35-44.
[29]Kumbhari V,Tieu AH,Onimaru M,et al.Peroral endoscopic myotomy(POEM)vs laparoscopic Heller myotomy(LHM)for the treatment of Type III achalasia in 75 patients:a multicenter comparative study[J].Endosc Int Open,2015,3(3):e195-e201.